"I've got to get away. Why do I even bother coming — no one cares that I'm here. I'm worthless. Nothing I say or do is ever right. I'm ugly, fat and lazy. I'll never amount to anything."

OK, so pep talks were never my strong suit. But what made those scathing inner monologues even more dangerous was how I'd try to silence the voices by "cutting." I would rush home, take a knife from my desk and escape to a private place where I'd carve wounds into my skin. Frantic self-abuse and physical pain drowned out the emotional pain I was feeling, if only for a short time. Nursing my wounds, I felt oddly comforted, guilty and aware that, next time, it would take even more pain to find that brief release. I was a freak with a secret. Little did I know how many teen cutters guard that same dark secret.

Experts call cutting "the new anorexia" because, like an eating disorder, it is a self-destructive attempt to control painful thoughts and unexpressed emotions. Current research places the number of self-injurers at about 4 percent of the general population, and as many as 10 percent of American teenage girls. Cutting is the most common form of self-harm, but up to 75 percent of all cutters rely on diverse methods, such as burning, pulling hair or punching walls.

In recent years, several books have been published on this topic. USA Network aired a TV movie about cutting and created an online lesson plan to provide resources to educators. Web sites and in-patient treatment programs such as SAFE (Self-Abuse Finally Ends) Alternatives have been developed to help the self-afflicted. Speaking of her own struggle with self-injury, the late Princess Diana shed light on cutting during a highly publicized 1995 BBC interview. She explained, "You have so much pain inside yourself that you try to hurt yourself on the outside because you want help."

Teens turn to self-injury as a way of dealing with emotional stress, usually stumbling upon self-abuse in a moment of desperation, rather than out of suggestion. A teen named Jamie said of her first experience, "It happened spontaneously. I picked up a piece of broken glass and cut my arm twice. It made me feel better because I could focus on one thing, injuring myself, instead of things that I couldn't control around me. That was something that I could control."

Some cutters avoid showing emotion, using self-abuse to express their hurt or anger. They often can't explain why they cut, or may simply lack the words to express themselves. "They have no language for their own feelings," says psychotherapist Steven Levenkron. "Cutting is the replacement for the absent language." Still others say they feel "dead" and turn to self-injury in order to be reminded that they're still alive. For them, enduring self-inflicted pain may seem like the only way they can feel anything at all.

Despite the way it may look, cutting is usually not a failed suicide attempt. Yet the progressive, addictive nature of the disorder can be life-threatening. The more desperate cutters become, the higher their risk of accidental suicide. Dr. Wendy Lader and Karen Conterio, directors of the SAFE Alternatives program, say one of the major reasons people seek them out is that they're petrified they'll go too far and accidentally kill themselves.

Journalist Marilee Strong, who interviewed more than 50 cutters for her book, A Bright Red Scream, says of self-injurers, "[They] are often bright, talented, creative achievers — perfectionists who push themselves beyond all human bounds, people-pleasers who cover their pain with a happy face." Often friends and family aren't aware that a loved one is cutting. It would seem the signs would be obvious, but cutters can be extremely creative at hiding their wounds. Here are some of the signs to look for in teens:

Unexplained bruises, cuts, burns or freshly healed scars, especially if coupled with other signs of being troubled. Favorite excuses are "I cut myself shaving" or "The cat scratched me."

A teen who describes herself as bored or unable to express emotions.

Wearing long, baggy clothing in the summer to cover the body. Note any unusual desire for privacy, such as a reluctance to change in gym class.

A normally outgoing person who retreats and doesn't want to talk to family and friends anymore.

Talking a lot about death, "being bad" or "needing to be punished." Language that expresses low self-worth such as describing oneself as ugly, fat, lazy or worthless.

A common thread among self-abusers is that they've lost sight of the truth. One female cutter explains it this way: "When you construct your worldview on a series of misunderstandings, it's like building a skyscraper with the foundation out of plumb. A fractional misalignment at the bottom becomes a whopping divergence by the time you get to the top." Jesus used this same picture of a faulty foundation in His parable of the foolish man who built his house upon the sand (Matthew 7:26). Cutters can begin building their houses on the rock of Christ by turning to His word for truth and leaving their misperceptions at the foot of the cross.

If you know someone struggling with cutting or other forms of self-injury, there are ways to break this dangerous cycle. You can begin by encouraging them to choose a confidant who will be supportive, nonjudgmental and willing to listen when times get tough. Assuming you're that person, help them find a Christian counselor who has worked with cutters (Focus on the Family can refer you to one in your area). Getting professional help is critical because a cutter needs to know his "triggers"—things that make him want to hurt himself. A therapist can create a plan for handling those situations. For me, journaling and painting provided healthy ways to combat inner turmoil. Others may find it therapeutic to jog, dance or play a musical instrument.

At a spiritual level, intercede for that person and urge them to talk to God as well. Pray they'll know and believe the truth. Search the scriptures for verses that will offer comfort and strength when they start to feel overwhelmed. For example, when voices of self-deprecation threatened to take hold, I reminded myself that the Creator of the universe values me deeply. I am His workmanship (Ephesians 2:10) created in His image (Genesis 1:27) and made complete in His son, Jesus Christ (Colossians 2:10). He has bought me with a great price (1 Corinthians 6:20, John 3:16), calls me His friend (John 15:15) and desires a relationship with me (1 John 1:3).

I spent 10 years as a cutter. But that's not who I am today. Four years ago I told my roommate about my problem, which started me down the road to emotional recovery. With the help of friends and loved ones, I began to experience the truth of Christ's love. I remained blinded by deception until I believed the truth that God loved me passionately and created me for a purpose (Jeremiah 29:11). The secrecy ended. My wounds healed. And although some days can be a trial, I've never regretted my decision to walk away.

A person enslaved by a pattern of self-abuse does not have to stay there. It may take a long time to recover. There may be temptations to cut, or even lapses on the path of healing. Teens need to know that "God is faithful; He will not let you be tempted beyond what you can bear. But when [not if] you are tempted, He will also provide a way out so that you can stand up under it" (1 Corinthians 10:13). Someone breaking the habit of self-injury can still be hit with destructive thoughts and feelings of worthlessness, but simply remembering and believing the truth can go a long way toward setting them free. Addressing the Galatians, the Apostle Paul told God's people to "stand firm and do not let yourselves be burdened again by a yoke of slavery" (Galatians 5:1). For the young cutter, that yoke can feel absolutely overwhelming. But I am living proof that there is hope!

Copyright 2003 Rachel Zoller. Used with permission. All rights reserved. Originally appeared in Focus on the Family's Dare 2 Dig Deeper teen booklet "Hurting Beyond Words: The Silent Agony of Self-Injury" and Plugged In Online.